Portuguese & British Nurses Fight Destruction of Health Systems

The health system in Portugal, like the NHS, has been an object of interest for the private sector for a very long time, reports Ana Vracar.

Portuguese nurses protesting during November 2022 strike. (Portuguese Nurses’ Union)

By Ana Vracar
Peoples Dispatch

When nurses across the United Kingdom went on strike on Dec. 15 and 20, 2022, their actions resonated well beyond the U.K., and nurses from different countries expressed their support. Among them were 125 nurses from Portugal who published an open letter in solidarity with their British comrades, reminding readers and patients that their own public health system faces many of the problems troubling the U.K.’s National Health Service.

Mário André Macedo, a specialist nurse and one of the first signatories of the letter, told People’s Health Dispatch that their initiative was inspired by both solidarity and a pressing need to point out the shortcomings that could bring the Portuguese public health service to its knees. In fact, the health system in Portugal shares a lot of similarities with the NHS, being itself inspired by the Beveridge model introduced in the U.K. 

While still drawing upon its positive association with public funding and universal access, things have been going downhill for the Portuguese public health system for years. If we look at the position of nurses in the system, their problems are as pressing as those of the health workers in the U.K. The professionals who signed the letter estimate that over the past decade or so, nurses in Portugal have faced a 20 percent wage loss — double of what nurses’ trade unions in the U.K. have reported.

During the same period, thousands of nurses have emigrated from Portugal to other countries, with the U.K. one of the preferred destinations. Many of those migrant nurses are now also on strike, points out Macedo, because they are aware of their responsibility towards fighting for good quality health services that are accessible to everyone.

The nurses who emigrated from Portugal to the U.K. are all too familiar with the background processes that have undermined public health systems, putting people’s right to health in danger.

Divide & Profit

The health system in Portugal, just like the NHS, has been an object of interest for the private sector for a very long time. In both cases, the goal of the private providers is to break down the systems, privatize the profitable parts, and leave what remains to a shrunken public budget.

The main losers in this scenario are, of course, the poor and the working class, who have no alternative but to seek care in the public sector, no matter its state.

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But it would be wrong to think that health workers are not harmed in the same process. Because of the dedication to austerity and public budget cuts that accompany attempts to commodify health systems, health workers’ rights have plummeted, leaving most of them overworked and burned out.

In Portugal, the failure of the government to adequately address nurses’ grievances over salaries and career progression led to the first country-wide strike in this profession since the beginning of the Covid-19 pandemic.

“Trade unions did not push for industrial action at the height of the pandemic, but the government’s first proposals for the regulation of our salaries and professional progression led to a landslide of support for this kind of action: at least 75 percent of the nurses supported going on strike,” says Macedo.

Cost of Living

Austerity protest in Lisbon, Portugal, February 2010. (E10ddie, CC 3.0, Wikimedia Commons)

Career progression might seem as an abstract reason to go on strike. In practice, the lack of a proper system has serious consequences. “Let’s say you’re a nurse who is retiring tomorrow. In case there is no change in the current system, your pension will be around 600 euros higher than the pension of a nurse who is now entering the workforce and who will accumulate the same experience and working hours as you have now,” says Macedo. 

He concedes that following the strike, the government has agreed to introduce certain provisions to value career progression. But they have decided to implement these provisions starting January 2023, without making any retroactive payments — which for some means a loss of thousands of euros.

The issue of increasing nurses’ salaries according to career progression became more difficult to ignore because of the growing inflation and increase of costs of living. Because there is no increase in salary in line with accumulated experience, around 80 percent of hospital and primary health care nurses earn a gross salary of around 1,500 euros. After taxes, their income rounds up to some 1,000 euros.

At the same time, rent prices for one-bedroom units in Lisbon and tourist regions like Algarve start at around 700-800 euros. It’s not a surprise, then, that those are the areas facing a serious shortage of nurses. It is literally impossible to make ends meet on a nurse’s wage in a single household.

Some of the trade unions remain cautiously content with the promises made by the government, hoping that they will be enough to catch up with what was lost in past years. Others — most notably the Portuguese Nurses’ Union (SEP), which spearheaded the strike in November — have already announced that they will continue to fight for a fairer deal.

As they do so, they will also be fighting for a better healthcare system. According to Macedo, “As health workers, we should protect the universal character of our health system. And since nurses are the most numerous group inside this system, we have the opportunity to make a particular impact.”

The nurses’ intention is to push for change at the local level, but also to build stronger relations with their counterparts in other countries.

“We can only win if we stand in solidarity and learn from each other. In some cases, the nurses’ position is better because the country channels more money towards the health system. But in most places, it is the workers’ struggles which actually make the difference, and we can only become stronger by connecting them,” concludes Macedo.

Ana Vracar is a correspondent for Peoples Dispatch

People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.

This article is from Peoples Dispatch.

The views expressed are solely those of the author and may or may not reflect those of Consortium News.

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4 comments for “Portuguese & British Nurses Fight Destruction of Health Systems

  1. X Fretensis
    January 5, 2023 at 15:23

    Note well that capitalisms biggest enemies are free health and free education. Add to that, governments that aspire to be truly representative of the people. Capitalism is one tree with many branches – time to prune, with a vengeance.

  2. Henry Smith
    January 4, 2023 at 15:10

    The problems within the UK NHS go much deeper than the fact that nurses are poorly paid.
    There are not enough nurses because the government refuses to train British nurses and prefers to steal from poorer countries already trained foreign nurses. Also, to fill nursing shortages agency nurses are used at many times the cost of a state nurse affecting budgets, competencies and morale. The major chunk of the NHS budget goes on managers and overpaid consultants, not to mention thousands of highly paid diversity and equality staff.
    Paying nurses more won’t solve the problems or stop the rot. A root and branch reorganisation is needed but it won’t happen as the government and senior doctors want privatisation not a functioning NHS. The NHS is being directed towards the american model by the capitalist establishment.

    • WellThere
      January 5, 2023 at 08:06

      “The NHS is being directed towards the american model by the capitalist establishment.”

      Yes that was/is one of the purposes of “Brexit” although they can’t find the exit, and “The war in Ukraine” to which they also can’t find the exit, and will again likely lose China and convene inquiries in hope of establishing, it was not me it was the others who had bad intentions because they are evil doers its in their nature.

    • Kirkwood
      January 6, 2023 at 16:24

      Frankly if the pandemic has taught us one thing, it’s that anyone who doesn’t suffer from collective amnesiac psychosis will by now have lost any faith they may have had in the public health system, and rightly so! It’s difficult not to conclude that the academic class has committed itself to this bizarre idea that we are slap bang in the middle of an “extinction level event” and if more than just a few of ‘”the great unwashed” depart the mortal coil as a result of an easily curable disease, “we” (ie: they) will be all the better for it.
      Or what; What is it these white collar goons are actually up to? Throwing billions at Nazis in central Europe while slashing healthcare services to ribbons in precisely the same region at precisely the same time. What could possibly go wrong?

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